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Open Access Research article

Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease

Peggy PC Chiang14, Ecosse L Lamoureux12, Anoop Shankar5, E Shyong Tai6, Tien Y Wong123 and Charumathi Sabanayagam134*

Author affiliations

1 Singapore Eye Research Institute, Singapore National Eye Centre, Level 6, 11 Third Hospital Avenue, 168751 Singapore, Singapore

2 Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia

3 Department of Ophthalmology, National University of Singapore, Singapore, Singapore

4 Duke-NUS Graduate Medical School, Singapore, Singapore

5 Department of Epidemiology, West Virginia School of Public Health, Morgantown, USA

6 University Medicine Cluster, National University Health System, Singapore, Singapore

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Citation and License

BMC Public Health 2013, 13:730  doi:10.1186/1471-2458-13-730

Published: 7 August 2013

Abstract

Background

Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore.

Methods

We examined data from Chinese (n = 1177), Malay (n = 774), and Indian (n = 985) adults aged 40–80 years who participated in three independent population based studies conducted from 2004–2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120–139 mm Hg or diastolic BP 80–89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders.

Results

The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables.

Conclusions

Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.

Keywords:
Prehypertension; Metabolic syndrome; Indian; Cardiometabolic